Treat SAD with light therapy

Tuesday

Dec 21, 2010 at 12:01 AMDec 21, 2010 at 9:17 PM

While taking vitamin D supplements is important, people with SAD respond best to full-spectrum light therapy. With this therapy, a person can get the light they need to improve their body's delicate balance of serotonin and melatonin, the hormone that regulates sleep.

Steve Bernardi and Dr. Gary Kracoff

It is important to know when emotional and physical changes brought on by the change in seasons are more serious than just a passing dislike.

Seasonal affective disorder, or SAD, affects many of us. Its symptoms are depression, lethargy and trouble “getting going” during the change of seasons, particularly during this time of year when the days get noticeably shorter and the temperature drops. It can also lead to cravings for certain types of food, such as carbohydrates, which tend to exacerbate the cycle.

The difference between SAD and other forms of depression is that SAD is markedly seasonal. It comes generally in late autumn and often is felt until early spring, at which point it begins to pass.

It should be noted that there is another form of SAD that comes during the spring and lasts through the summer, but the causes and treatments for this rare form are less understood.

The cause of classic fall and winter SAD is believed to be the decrease in sunlight, which leads to lower production of vitamin D –– a topic we covered in last month's column –– which leads to decreased production of serotonin, the neurotransmitter that regulates moods and general feelings of well-being.

While taking vitamin D supplements is important for anyone who does not naturally have enough exposure to vitamin D, people with SAD respond best to full-spectrum light therapy. With this therapy, a person can get the light they need to improve their body's delicate balance of serotonin and melatonin, the hormone that regulates sleep, resulting in greatly diminished effects, or even elimination altogether.

Here is how it works: A full-spectrum light box should ideally be used first thing in the morning for 20 or 30 minutes. A person does not need to sit directly in front of or next to the light box, but it should be within an arm's reach. It can be positioned on a table while a person watches television or reads the newspaper or a book. It can also be placed on a counter during a person's morning grooming routine.

Visitors to our store often tell us they begin to feel better within a week of using the light box. It is important to begin using it early in the season and to be consistent with its use. Turning the light box on every once in a while, even during different hours of the day, will not likely yield the optimal result. Nor will moving around the room while the light box sits on a counter.

Once dismissed by clinicians as the "winter blues," SAD has become a fully accepted condition in the fields of medicine and psychology. The American Psychiatric Association's diagnostic manual defines SAD as a specified, or sub-type, of a major depressive episode.

But the good news is SAD can, in many cases, be treated without the medications that generally are used to treat depression. The answer can be as simple as a light box. And with the newfound acceptance of SAD comes coverage of light box therapy, as long as it is prescribed by a physician. Some major health plans are providing full reimbursement for the light boxes, which can be purchased for under $200.

It is important to note that some people will not fully respond to light box therapy and will require treatments similar to those used in patients with depression, such as talk therapy and antidepressant medication.

However, we see light box therapy working with many patients, who in turn are quick to extol its virtues.

Nobody should feel forced to live with SAD when an effective treatment is so readily available and relatively easy to use. While sitting near a light for 20 to 30 minutes first thing in the morning does require a commitment, it is important to keep in mind that it is a treatment that is pain-free, has none of the side effects of medication and is reasonably inexpensive.

We can't change the weather, but we can improve the way that our bodies respond to it. Like many other illnesses or disorders, the key is to recognize the symptoms and to be willing and ready to act.

Steve Bernardi is a compounding pharmacist and Dr. Gary Kracoff is a registered pharmacist and a naturopathic doctor at Johnson Compounding and Wellness Center in Waltham, Mass. (www.naturalcompounder.com) Readers with questions about natural or homeopathic medicine, compounded medications, or health in general can e-mail steveandgary@naturalcompounder.com or call 781-893-3870.